Spotlight: ‘Good’ Death Drives Breast Cancer Specialist

When she was 10, treatment for a knee problem became a life-changing experience for the young Hope Rugo. She was fascinated by the view of her knee on a fluoroscopy screen and knew that she wanted to be a doctor.

“This is really what I want to do,” she remembers thinking. “I was just a little kid then, and I never really changed my mind.”

Rugo, who grew up in a small town outside Boston as the daughter of a biophysicist, was drawn to science from an early age. She still remembers the Sears chemistry set she got when she was 7. “Science was a cool thing that not a lot of girls did, and that was part of the attraction,” she says.

In high school, she pursued her interest in medicine by volunteering in a local hospital’s operating room and at a nearby research lab.

Rugo is now a professor of medicine at UCSF’s Helen Diller Family Comprehensive Cancer Center and directs the center’s Breast Oncology and Clinical Trials Education Program. She leads a variety of clinical trials that combine new medications with standard treatment to improve treatment options for women with breast cancer.

Rugo decided to specialize in hematology/oncology during her UCSF residency. Amid rotations, when she was caring for cancer patients, she became fascinated with the biology and treatment of cancer. She went on to complete a fellowship in hematology/oncology at UCSF that included two research years at Stanford University.

“I knew that what I really liked to do was to take care of people, and to understand more about the way cancers grow. I wanted to improve patient care as well as to increase the probability of their treatments being successful,” Rugo says.

Rugo returned to UCSF after the research portion of her fellowship, where she worked in malignant hematology and bone marrow transplantation.

In 1998, Rugo’s mother, a 12-year breast cancer survivor — whom Rugo describes as her best friend — died from metastatic disease. That helped Rugo decide to focus her formidable energies on breast cancer research and patient care.

Helping her mother die what Rugo calls "a good death” at home was a powerful experience. “I was there for her in the way I had always promised her I would be,” she says.

Today, Rugo throws herself into the teamwork that she says is crucial to guiding research efforts. The goal is to learn from patients, and bring laboratory discoveries to patients as quickly as possible.

“It doesn’t need to be me that finds the new discovery. I just want to be part of the team that does it,” Rugo says. “This is teamwork, a collaborative work. And part of what makes our work here great is that we are an amazing team.”

Community physicians are another essential part of that team, says Rugo. She enjoys helping them get their patients into UCSF clinical trials that may offer beneficial treatment.

One patient who was helped by a clinical trial stands out for Rugo. The woman had been diagnosed with breast cancer only after it had become dangerously advanced.

Rugo’s team treated the woman with a newly approved medication and saved her life. “She was cured because we had a new approach,” says Rugo. “She would have been dead in two years otherwise. It was a huge validation of our team’s efforts.”

Combining research with patient care is the best of both worlds for Rugo — it’s how she prefers to practice medicine.

“My goal is to help the patients be as educated as they can be, so they will know that we’re supporting them, to know that there’s an open door for questions,” says Rugo. “Our team makes UCSF a unique place to get care and look for studies patients might want to be part of. It’s a great community resource.”